| NPI | 1750346367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 00016495) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AL 16495) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2016-07-11 |